Hospital Case Management 2009-09-01

Health care reform likely to penalize hospitals for readmissions

Now that hospitals' 30-day readmission rates for heart failure, heart attack, and pneumonia are being posted on the Hospital Compare web site, the stage is set for the Centers for Medicare & Medicaid Services (CMS) to start reducing or eliminating payments for patients who are readmitted to the hospital.

Analyze readmission rates to see why patients return

If hospitals are going to avoid penalties for 30-day readmissions, they need to start now to identify their own patterns of what caused the readmissions and use that information to improve the discharge plan, suggests Jackie Birmingham, RN, MS, CMAC, vice president of professional services for Curaspan Health Group, a Newton, MA, health care technology and services firm.

Proactive approach results in lower readmission rates

When the Centers for Medicare & Medicaid Services (CMS) analyzed hospital readmission rates to post them on the Hospital Compare web site, the lowest heart failure readmission rate in the nation was at the Baylor Jack and Jane Hamilton Heart and Vascular Hospital.

Critical Path Network: Electronic CM system optimizes data, patient flow

Sutter Health's Sacramento Sierra Region's customized electronic case management system with embedded InterQual criteria enables the case management department to track everything from individual case manager performance to regional outcomes.

Critical Path Network: Review of one-day stays improves documentation

At Sutter Health's Sacramento (CA) Sierra Region, case manager supervisors at each hospital conduct a secondary, retrospective review of 100% of one-day stays of Medicare patients to ensure that the individual case managers are making the right determination and using any deficits they uncover as an educational opportunity.

Critical Path Network: Multidisciplinary meetings lower LOS, excess days

Within 45 days after daily multidisciplinary patient care conferences were instituted at North Fulton Regional Hospital, the hospital's average length of stay dropped by more than a day and excess days decreased by more than 300 days within the first quarter of implementation.

CMS changes wording of orders for observation

In an effort to clarify what had been confusing in the past, the Centers for Medicare & Medicaid Services (CMS) changed the wording of the observation orders and admission status, effective July 1.

Ambulatory Care Quarterly: Complications in chest pain patients in crowded EDs

Patients with heart attacks and other forms of chest pain are three to five times more likely to experience serious complications after hospital admission when they are treated in a crowded ED, according to a new study published online in the journal Academic Emergency Medicine.

Ambulatory Care Quarterly: Education reduces peds asthma readmits

The medical literature shows that educating children and their parents about asthma can reduce return visits to the ED as well as hospital admissions, and experts say the ED may well be the best place to provide that education.

Ambulatory Care Quarterly: D-to-D slashed 85% — in seven weeks!

The ED at Twin County Regional Hospital in Galax, VA, succeeded in cutting its door-to-doc time from 121 minutes to 19 minutes in just seven weeks while annual volume was climbing from 19,000 to about 30,000 by combining a process improvement plan designed by a health care consulting firm, the leadership of the hospital CEO, and the ED's medical director.

Hospital Case Management – September 1, 2009

September 1, 2009